Hepatitis C virus (HCV) is a major cause of chronic liver disease in women, and in pregnant women can be transmitted to the fetus.
The presence of a positive antibody to HCV gives no indication of the extent of viremia, or the severity of the underlying liver disease. Therefore, it is important to obtain an RNA viral load on women who test positive. Fortunately, the vast majority of infected women remain asymptomatic and have good pregnancy outcomes.
Risk of Transmission of HCV to the Fetus
Although there is a risk of transmission, the exact risk is unknown since it has varied amongst several studies. The risk appears to be approximately 5 to 10% and is higher in women who also have HIV. Unlike the transmission of HIV, cesarean delivery does not appear to lower the risk of HCV transmission, and breastfeeding does not appear to increase the risk. Therefore, HCV is not a reason for a cesarean delivery nor a reason to avoid breastfeeding. The level of viremia appears to correlate with the risk of transmission, which makes sense. However, exact cutoffs and risks are unknown.
Most women with HCV have uneventful pregnancies and do not experience liver failure. During pregnancy, it is important to have regular follow-up appointments with a specialist, such as a gastroenterologist or hepatologist.
If you have any questions about HCV and pregnancy, feel free to contact us today. We would be happy to answer any questions you may have.
Invasive Testing in Pregnant Women with HCV
Unfortunately, it is unknown if invasive testing (CVS, amniocentesis) increases the risk of transmission of HCV to the fetus, or to what degree. Due to this, invasive tests are typically recommended for women considered to be at very high risk. However, since the risk cannot be quantified, invasive testing is an option for women who request it, but they must be very informed about the possibility of transmitting HCV to the fetus.
Maternal Fetal Medicine blogs are intended for educational purposes only and do not replace certified professional care. Medical conditions vary and change frequently. Please ask your doctor any questions you may have regarding your condition to receive a proper diagnosis or risk analysis. Thank you!